The present invention relates to a surgical ophthalmic procedure for performing a medial canthoplasty. More particularly, the present invention relates to a surgical oculoplastic procedure for performing a medial orbicularis flap canthoplasty to tighten the medial canthal tendon and may include a medial alternative to a lateral tarsorrhaphy as an option to further close the eye.
Upon aging, the lower eyelid becomes lax and ectropic, a condition in which the eyelid turns outwardly and no longer tight against the globe leaving the inner eyelid surface exposed and prone to irritation, typically resulting in tearing and discomfort. The most common way to surgically correct this condition is a lateral canthal tightening procedure which is relatively easy to perform. The medial aspect of the eyelid may continue to be ectropic in spite of the lateral canthal tightening procedure and is difficult to fix surgically because of the absence of a tarsus medially and the medial presence of the lacrimal drainage system which includes the puncta and the canaliculus.
Numerous medial canthoplasty procedures to correct medial laxity and ectropion have been described in the medical literature. Typically, these procedures use skin flaps in conjunction with lower eyelid lid shortening procedures and tarsal resuspension to the medial canthal tendon; however most medial canthoplasty procedures are difficult and don't achieve the functionally successful result of tightening and lifting the medial eyelid and correcting the ectropion of the medial lid margin and the punctum without damaging the lacrimal drainage system.
If the eyelid is paralyzed or extremely ectopic, lid closure more than provided by a lateral canthal tightening is required to protect the cornea from exposure. Laterally, this is achieved by performing a lateral tarsorrhaphy, which consists of suturing the tarsus of the lower lid to the tarsus of the upper lid. Medially, suturing the tarsi together is not possible as each tarsus ends at the puncta and is not present medial to the puncta.
For the foregoing reasons, there is a need for a surgical ophthalmic procedure for performing a medial orbicularis flap canthoplasty to tighten the medial canthal tendon and which provides a medial alternative to a lateral tarsorrhaphy as an option for further close of the eye.